Abstract:Objective:To analyze the proteomic profile changes in EV71-infected human glioblastoma U251 cells using pro-teomics technology,and to elucidate the potential molecular mechanisms underlying EV71-induced cytopathic effects.Methods:The EV71 virus with an MOI of 0.1 was inoculated into the human glioblastoma cell line U251 to establish an in vitro infection model.Cytopathic effects(CPE)were observed under an optical microscope,cell proliferation viability was assessed via CCK-8 assay,viral capsid protein VP1 expression was detected by Western blot and immunofluorescence,and high-throughput pro-teomics was employed to analyze differential protein expression profiles.Results:EV71 infection induced typical CPE in U251 cells,reduced proliferation and survival rates.Western blot and immunofluorescence confirmed elevated VP1 protein expression post-infection compared to controls.Proteomic analysis identified 6,326 proteins,with 103 upregulated and 106 downregulated.The GO function and KEGG pathway enrichment analyses indicated that the differentially expressed proteins were primarily en-riched in the lysosome pathway(downregulated),antigen processing and presentation(downregulated),and metabolic path-ways(upregulated).Conclusion:EV71 infection altered the proteome of U251 cells,with the underlying mechanisms possibly associated with the inhibition of lysosomal and antigen presentation functions,as well as the activation of cellular metabolic pathways.

Abstract:Objective:To investigate the effect and mechanism of miR-126-3 p on the migration and invasion of lung adeno-carcinoma cells.Methods:Predict downstream target genes of miR-126-3p via database and perform enrichment analysis on them.Lung adenocarcinoma cells PC9 and A549 were cultured,and miR-126-3p inhibitor,pcDNA3.1-BCL and si-BCL2 were transfected into A549 and PC9 cells,which were divided into miR-126-3p inhibitor group and inhibitor NC group,pcDNA3.1-BCL2 and pcDNA3.1 groups,miR-126-3p inhibitor+si-BCL2 groups.RT-QPCR detectes the mRNA expression levels,and Western blot detectes the protein expression.Scratch assay and Transwell assay detecte the migration and invasion ability of PC9 and A549 cells.The binding of miR-126-3p to BCL2 was confirmed by dual luciferase reporter Gene Assay.Results:BCL2 was a target gene of miR-126-3p,and enrichment analysis results revealed key functions and pathways related to cell migration and invasion.RT-qPCR showed that miR-126-3p was overexpressed in PC9 and A549 cells compared to normal lung epithelial cells(P＜0.05),while BCL2 was underexpressed in PC9 and A549 cells compared to normal lung epithelial cells,and the ex-pression level of BCL2 was increased after inhibition of miR-126-3p(P＜0.05).Scratch assay and Transwell assay showed that the migration rate and invasion rate of miR-126-3p inhibitor group were lower than those of inhibitor NC group(P＜0.05).The mobility and invasion rate of pcDNA3.1-BCL2 group were lower than those of pcDNA3.1 group(P＜0.05).The migra-tion rate and invasion rate of miR-126-3p inhibitor+si-BCL2 group were higher than those of miR-126-3p inhibitor group(P＜0.05).Western blot analysis of BCL2 protein showed that the histone of miR-126-3p inhibitor was higher than that of inhibitor NC group(P＜0.05),and the histone of miR-126-3p inhibitor+si-BCL2 was lower than that of miR-126-3p inhibitor group(P＜0.05).Conclusion:miR-126-3p promotes the migration and invasion of Lung adenocarcinoma cells by targeting BCL2.

Abstract:Objective:This study integrates network pharmacology,molecular docking,and experimental validation to sys-tematically investigate the mechanism of Periplaneta americana extract in treating neuroblastoma(NB).Methods:The core components of Periplaneta americana extract were identified through PubMed and CNKI databases.Potential targets were pre-dicted using the SwissTargetPrediction database,while NB-related targets were analyzed through OMIM,GeneCards,and Dis-GeNET databases,with intersection targets determined using the Weishengxin platform.Protein-protein interaction(PPI)net-works were constructed using the STRING database,followed by GO functional and KEGG pathway enrichment analyses via the DAVID database.Molecular docking validation was performed using AutoDock Tools.The anti-proliferative effects on NB cells were evaluated through CCK-8 and colony formation assays.Apoptosis induction and cell cycle effects were assessed by flow cytometry,with Western blotting employed to detect Bax and Bcl-2 expression levels.Results:17 peptide-based active com-ponents and 323 potential therapeutic targets were identified.Enrichment analysis suggested the extract exerts anti-NB effects through apoptosis-related signaling networks.Molecular docking confirmed stable binding between core components and key targets.CCK-8 assays demonstrated significant inhibition of NB cell proliferation(P＜0.05)without notable cytotoxicity to normal cells.The extract dose-dependently reduced clonogenic capacity and promoted tumor cell apoptosis.Conclusion:Peripla-neta americana extract synergistically inhibits NB cell proliferation and induces apoptosis through multi-target mechanisms and pathway regulation.

Abstract:Objective:To explore the correlation between the onset of osteoporosis(OP)and the levels of blood lipids,blood glucose and serum uric acid.Methods:The clinical data of 447 patients who came to our hospital for bone mineral density(BMD)screening were retrospectively analyzed,and they were divided into osteoporosis group(n=119)and non-osteoporosis group(n=328)according to the results of BMD T-value.The general data,lumbar spine(L,-L4)BMD,uric acid(UA),blood glucose(GLU),blood lipid and other index levels and their correlation with OP were compared between the two groups.Re-sults:There were statistically significant differences in gender,L-L4 bone mineral density,uric acid,fasting blood glucose,and total cholesterol between the two groups.Multivariate Logistic regression analysis showed that total cholesterol,uric acid,fast-ing blood glucose were independent risk factors for OP.The receiver operating characteristic(ROC)curve analysis showed that UA,fasting GLU and total cholesterol had certain predictive value for the occurrence of OP,and the combined performance of the three had a higher efficacy.Conclusion:In the risk of OP,total cholesterol,UA,and fasting GLU are independent risk fac-tors,and the combination of these indicators has a higher predictive power for OP.

Abstract:Objective:To investigate the effects of piperazine ferulate combined with prednisone on immunoglobulins,bone metabolism and lipids in patients with nephrotic syndrome.Methods:120 patients with nephrotic syndrome were included as study subjects,grouped according to the actual treatment,divided into the control group(prednisone treatment)and the combi-nation group(combined with ferulic acid piperazine treatment on the basis of the control group),60 cases in each group.The treatment efficiency,immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),glutamic transaminase(AST),blood creatinine(SCr),blood urea nitrogen(BUN),24 h urine protein volume,parathyroid hormone(PTH),osteocal-cin(BGP),25-hydroxyvitamin D,total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),and the incidence of adverse reactions were recorded and compared between the two groups.Results:The efficacy rate of the observation group was higher than that of the control group(P＜0.05).After treat-ment,compared with the control group,the observation group showed higher levels of IgA,IgG,IgM,BGP,25-hydroxyvitamin D,and HDL-C(P＜0.05),and lower levels of SCr,BUN,24 h urinary protein,PTH,TC,TG,and LDL-C(P＜0.05).There were no statistically significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclu-sion:The combination of ferulic acid piperazine and prednisone is beneficial for regulating immune function in patients with ne-phrotic syndrome,helps improve bone metabolism disorders and kidney function,and reduces patients'blood lipid levels.It has a good safety profile and demonstrates significant overall therapeutic efficacy.

Abstract:Objective:To investigate the composition and antibiotic resistance patterns of clinical bacterial isolates from the Affiliated Hospital of North Sichuan Medical College between 2021 and 2024,to provide a scientific basis for the rational use of antimicrobial agents and hospital infection control.Methods:We collected data on clinical bacterial isolates and their antimicrobi-al susceptibility test results.The data were analyzed using the WHONET 5.6 software.Results:A total of 38423 non-duplicate bacterial isolates were identified during the study period,with Gram-positive bacteria accounting for 30.6％and Gram-negative bacteria for 69.4％.The top five specimen types by isolate count were sputum,pus,urine,blood and bronchoalveolar lavage flu-id.The most frequently isolated bacteria were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Haemophilus in-fluenzae,and Pseudomonas aeruginosa.The overall detection rates for methicillin-resistant Staphylococcus aureus(MRSA)was 32.0％.Vancomycin resistance was observed in 0.5％of Enterococcus faecalis isolates,with no vancomycin-resistant Entero-coccus faecium detected.The resistance rates to linezolid for Enterococcus faecalis and Enterococcus faecium were 0.5％and 2.8％,respectively.The detection rates for carbapenem-resistant Escherichia coli,Klebsiella pneumoniae,and Enterobacter cloa-cae were 1.4％,7.0％and 5.4％,respectively.The detection rates for carbapenem-resistant Pseudomonas aeruginosa and Acin-etobacter baumannii were 7.4％and 56.6％,respectively.Conclusion:While the composition and resistance rates of the isolated bacteria showed little variation from 2021 to 2024,there was an increase in resistance rates for Enterobacter cloacae to carbapen-ems,Enterococcus faecium to linezolid and Acinetobacter baumannii to minocycline and tigecycline.Continuous surveillance and enhanced management of antimicrobial use and hospital infection control are warranted.

Abstract:Objective:To study the correlation between ProMisE molecular classification of endometrial cancer and lymph node metastasis and clinical features.Methods:1,056 endometrial cancer patients were selected as the research subjects.The ProMisE molecular typing results,lymph node metastasis,and indicators of clinical characteristics were analyzed.The correla-tion of patient ProMisE molecular subtyping with lymph node metastasis and clinical characteristics was analyzed.Results:A-mong the 1,056 patients,the ProMisE molecular typing as MMRD totaled 384 cases,accounting for 36.36％.In total,72 cases were POLE EDM subtype,accounting for 6.82％,p53abn was total of 96 cases,accounting for 9.09％.The p53wt totaled 504 cases,accounting for 47.73％.The proportion of p53wt was higher than that of POLE EDM and p53abn(P＜0.05).The posi-tive ProMisE molecular classification of endometrial cancer was positively associated with lymph node metastasis,clinical sta-ges,CA1 2 5 and CA199(r=0.572,0.641,0.778,0.804,P=0.002,0.002,0.002,0.001),and showed no obvious correlation with age,WBC and ANC(r=0.119,0.251,0.187,P=0.104,0.573,0.311).Conclusion:The ProMisE molecular classification of endometrial cancer is closely associated with lymph node metastasis,clinical stages,CA125 and CA199,and has no obvious association with other clinical features,which deserves clinical attention.

Abstract:Objective:To investigate the expressions and clinical significance of E-cadherin and cyclin D1 in cutaneous squa-mous cell carcinoma(SCC)and basal cell carcinoma(BCC).Methods:The specimens of 96 patients with BCC were collected as BCC group,and the specimens of 80 patients with SCC were collected as SCC group.All specimens were clearly diagnosed.Im-munohistochemistry was used to detect the expression levels of E-cadherin and cyclin D1 in the specimens,and an analysis of correlation with clinicopathological characteristics was conducted by Spearman correlation analysis.Kaplan-Meier analysis was used to evaluate the relationship with survival prognosis.Results:In BCC and SCC groups,the positive expression rates of E-cadherin were 58.33％and 42.50％,and the positive expression rates of cyclin D1 were 30.21％and 60.00％,respectively(P＜0.05).A positive correlation was observed between positive state of E-cadherin and differentiation degree(P＜0.05),and showed a negative correlation with TNM staging as well as lymph node metastasis(P＜0.05),but Cyclin D1 revealed the op-posite correlation(P＜0.05).After 1 year of follow-up,patients with positive E-cadherin expression had longer progression-free survival time compared to those with negative expression(P＜0.05).Patients with positive cyclin D1 had shorter progres-sion-free survival time than those with negative expression(P＜0.05).There was no difference in survival time between stage I-Ⅱ patients with negative and positive E-cadherin(P＞0.05),and the survival time in stage Ⅲ patients with positive expres-sion was longer than that in patients with negative expression(P＜0.05).The survival time in stage I-Ⅱ patients with positive expression of cyclin D1 was shorter than that in patients with negative expression(P＜0.05),but there was no difference in stage Ⅲ patients(P＞0.05).Conclusion:The expressions of E-cadherin and cyclin D1 in BCC and SCC are different,and are closely related to clinicopathological characteristics,suggesting that the high expression of E-cadherin and low expression of cyc-lin D1 indicate a relatively good prognosis in BCC/SCC patients,which can be used as indicators for prognosis judgement.

Abstract:Objective:To evaluate the prevalence of C-shaped canals and radicular grooves(RG)in mandibular premolars using cone-beam computed tomography(CBCT)and explore the correlation between these features,gender and bilateral sym-metry.Methods:CBCT images of 272 patients with an age group of 60～70 years were selected from pre-existing database.The prevalence of C-shaped canal and RG was recorded along with variables such as age,sex,and bilateral prevalence.Results:The prevalence of C-shaped configurations in the mandibular fist premolars was higher than the mandibular second premolars(12.5％vs.0.93％,P＜0.05).CBCT analysis revealed that in cervical third,84.29％of canals were found to be C4 type.A high prevalence of C2 type canal was found in middle(65.71％)and apical third(34.29％).The prevalence of RG in the man-dibular first premolars was higher than the mandibular second premolars(13.85％vs.3.08％,P＜0.05).Conclusion:This study showed a high prevalence of C-shaped canals and RG in mandibular fist premolars as compared with mandibular second premolars.Except the gender factor,the incidence of C-shaped root canal and RG symmetry is higher.Compared with other re-search methods,in vivo CBCT is more accurate and efficient for assessing the complex structure of the root canal configuration(such as C-type root canal and Radicular groove).

Abstract:Objective:To examine longitudinal associations between dynamic changes in anticoagulant protein(AT,PC,PS)activity and anticoagulation efficacy in lower extremity deep vein thrombosis(DVT)patients.Methods:220 DVT patients received standard LMWH-warfarin therapy.Serial measurements of AT,PC,PS activity and imaging parameters(thrombus volume,venous obstruction rate,collateral circulation,venous wall thickness,blood flow velocity)were taken at baseline(T0),1 week(T1),1 month(T2),and 3 months(T3).Associations were analyzed using linear mixed models(LMM)and Cox regres-sion.Results:Patients were stratified by 3-month efficacy:ineffective(n=31)and effective(n=189)groups.The effective group had lower age,treatment delay,hereditary thrombophilia family history,and ≥2 comorbidities(P＜0.05).In the effec-tive group,the activities of AT,PC,PS demonstrated continuous increases from T1 to T3,reaching peak levels at T3(P＜0.05),whereas no significant changes in activity were observed at any time point in the ineffective group(P＞0.05).At the T1 assessment,no statistically significant differences were found in imaging indices between the two groups(P＞0.05).During the T1,to T3 period,the effective group showed continuous declines in thrombus volume,venous obstruction rate,and ve-nous wall thickness(P＜0.001),accompanied by parallel improvements in collateral circulation grading and blood flow velocity(P＜0.001).In contrast,the ineffective group exhibited no significant changes in imaging indices during T1 to T3(P＞0.05).LMM revealed significant positive associations between combined AT,PC,PS exposure and efficacy(P＜0.05).Cox regression identified AT≤70％,PC≤65％,and PS≤55％as independent predictors of poor efficacy(P＜0.05).Conclusion:Dynamic AT,PC,PS monitoring predicts anticoagulation efficacy early.Insufficient activity recovery correlates with delayed thrombus regres-sion,guiding individualized therapy.

Abstract:Objective:To investigate the correlation between renal function indicators and the occurrence of cerebrovascular diseases in patients with renal failure.Methods:A total of 132 patients with renal failure were included in the study,and were di-vided into two groups based on the occurrence of cerebrovascular diseases:the cerebrovascular event group(n=26)and the non-cerebrovascular event group(n=106).The general data and various renal function indicators[serum creatinine(Cr),blood urea nitrogen(BUN),uric acid(UA),cystatin C(Cys-C),β2-microglobulin(β2-MG),urine albumin-to-creatinine ratio(ACR),and estimated glomerular filtration rate(eGFR)]were compared between the two groups.Multivariate Logistic regres-sion analysis was used to identify the risk factors for cerebrovascular disease in patients with renal failure.Spearman's method was employed for correlation analysis,and receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of each indicator for the occurrence of cerebrovascular diseases.Results:The levels of Cr,Cys-C,β2-MG,and ACR in the cerebrovascular event group were higher than those in the non-cerebrovascular event group(P＜0.05),while eGFR was lower in the cerebrovascular event group(P＜0.05).Regression analysis showed that Cr(OR=1.148),β2-MG(OR=2.073),and ACR(OR=1.018)were identified as independent risk factors for cerebrovascular events(P＜0.05).Correlation analysis showed that the levels of Cr,Cys-C,β2-MG,and ACR were positively correlated with the occurrence of cerebrovascular diseases,while eGFR was negatively correlated with cerebrovascular diseases(P＜0.05).The ROC curve analysis showed that the combined prediction model using Cr,β2-MG,and ACR had an area under the curve(AUC)of 0.955(95％CI:0.915～0.994),with a sensitivity of 96.2％and specificity of 80.8％.Conclusion:Cr,Cys-C,β2-MG,ACR,and eGFR are correlated with the occurrence of cerebrovascular diseases in patients with renal failure.Elevated Cr,β2-MG,and ACR are independent risk factors for cerebrovascular diseases.The combined use of Cr,β2-MG,and ACR offers a good predictive value for cerebrovascular diseases.

Abstract:Objective:To investigate the effect of esketamine combined with erector spinae plane block(ESPB)on postop-erative pain and sleep quality in patients undergoing lobectomy.Methods:88 patients with thoracoscopic lobectomy were divided into control group and observation group according to different anesthesia scheme,44 cases in each group.ESPB was performed in both groups,and the same anesthesia induction and maintenance were given.Before skin incision,the observation group was given intravenous injection of esketamine 0.5 mg/kg,and 0.25 mg·kg-1·h-1 was pumped during the operation until 30 min be-fore the end of the operation.The control group was injected with the same dose of normal saline.The pain scores of the two groups were recorded at 2,6,24 and 48 h after operation.The intraoperative dosage of propofol and remifentanil was recorded,and the pressing times of analgesia pump in the two groups were counted.The Pittsburgh sleep quality index(PSQI)was eval-uated on the 1 st day before operation and on the 1 st and 2 nd day after operation.The levels of serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected before and 24 h after operation.Statistically analyzed the occurrence of adverse reactions.Results:Compared with the control group,the pain score of the observation group was lower at 2,6,24 h after opera-tion(P＜0.05).48 hours after surgery,there was no statistically significant difference in pain scores between the two groups(P＞0.05).Compared with the control group,the dosage of propofol and remifentanil in the observation group was less(P＜0.05).Compared with the control group,the PSQI score of the observation group was lower at 1 and 2 d after operation(P＜0.05).At 24 h after operation,the levels of serum TNF-α and IL-6 in the two groups increased(P＜0.05),and the observation group were lower than the control group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Esketamine combined with ESPB in thoracoscopic lobectomy can not only reduce postoperative pain,but also inhibit inflammatory response,improve postoperative sleep,and has good safety.

Abstract:Objective:To evaluate the efficacy of a four-step massage technique assisting urokinase thrombolysis in patients with acute thrombosis of autologous arteriovenous fistula(AVF)and to preliminarily explore the therapeutic mechanism.Meth-ods:A total of 108 patients with acute thrombosis due to AVF during maintenance hemodialysis were selected as the research subjects and divided into the control group and the observation group according to different treatment methods.54 cases in the observation group were treated with urokinase thrombolysis combined with four-step manual massage,while 54 cases in the control group were given urokinase thrombolysis.The thrombolytic effect,coagulation function related indicators before and af-ter treatment,inflammation and thrombosis were compared between the two groups to evaluate the efficacy and safety.Results:The total effective rate of the observation group was higher than that of the control group(P＜0.05).The thrombolysis time in the observation group was shorter than that in the control group,the per capita dosage of urokinase was less than that in the control group,the inner diameter of the fistula and the blood flow at the internal fistula were greater than those in the control group,and the thrombolysis rate was higher than that in the control group(P＜0.05).After treatment,the activated partial prothrombin time(APTT)and prothrombin time(PT)in the observation group were longer than those in the control group.The D-dimer(D-D)was lower than that of the control group,C-reactive protein(CRP),soluble endothelial cell protein C recep-tor(sEPCR),and high mobility group protein B1(HMGB1)were lower than those in the control group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups of patients during treatment(P＞0.05).Conclusion:The four-step massage technique combined with urokinase thrombolysis can shorten the thrombolysis time in patients with acute AVF thrombosis,reduce the amount of urokinase required,and improve efficacy.The mechanisms may involve promoting local blood circulation,reducing systemic inflammatory responses,and enhancing coagulation system functions to achieve therapeutic goals.

Abstract:Objective:To investigate the expression level of serum microRNA(miR)-101 in the diagnosis of cervical canc-er and its relationship with clinicopathological parameters.Methods:76 patients with cervical cancer(cervical cancer group),50 patients with cervical intraepithelial neoplasia(CIN)(CIN group)and 50 patients with benign uterine lesions(control group)diagnosed were selected.The differences of serum miR-101 expression and general data among the three groups were compared.Logistic regression model was used to analyze the influencing factors of cervical cancer.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of miR-101 for cervical cancer,and its relationship with different clinical path-ological parameters in cervical cancer patients.Results:The relative expression of serum miR-101 in cervical cancer group was(0.48±0.14),which was lower than that in CIN group(0.93±0.17)or control group(1.01±0.19),and the difference was statistically significant(P＜0.05).Logistic regression analysis showed that HR-HPV infection and serum miR-101 level were the influencing factors of cervical cancer(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of serum miR-101 for diagnosing cervical cancer was 0.886(95％CI:0.829～0.929).There was no statistically significant difference in the expression levels of serum miR-101 among cervical cancer patients of different ages,menopausal status,and tumor diameter(P＞0.05),but there was a statistically significant difference in the expression levels among different pathological stages,lymph node metastasis,and vascular infiltration(P＜0.05).ROC curve analysis showed that serum miR-101 had certain diag-nostic value for pathological stage(AUC=0.792),lymph node metastasis(AUC=0.755)and vascular invasion(AUC=0.730)of cervical cancer.Conclusion:miR-101 is lowly expressed in the serum of patients with cervical cancer and is associated with the malignant degree of cervical cancer,which can be used as a screening marker for cervical cancer.

Abstract:Objective:To observe the therapeutic effect of quadruple therapy combined with Rebamipide and probiotics in the treatment of Helicobacter pylori(Hp)positive gastric ulcers.Methods:120 patients with Hp-positive gastric ulcer were di-vided into control group(n=60,conventional quadruple therapy)and combined group(n=60,addition of rebamipide combined with probiotics)according to different treatment methods.The two groups were compared in terms of total effective rate of treatment and changes of serum peptide gastrointestinal hormones[motilin(MTL),gastrin(Gas),somatostatin(SS),ad-renomedullin(AM)]and T lymphocyte subsets before and after treatment,and the histopathological conditions under gastrosco-py and adverse reactions were compared.Results:Compared with the control group,the combined group had higher total treat-ment effective rate(P＜0.05).The MTL,Gas and AM in the combined group after treatment were lower(P＜0.05)while the SS was higher compared to the control group(P＜0.05),and the CD3+and CD4+levels were higher(P＜0.05)while the CD8+level was lower(P＜0.05).Compared with the control group,the gastric mucosal epidermal injury score was lower in the combined group after treatment(P＜0.05),and the Hp eradication rate was higher(P＜0.05).Conclusion:Rebamipide combined with probiotics for patients with Hp-positive gastric ulcer can enhance the Hp eradication rate,improve the levels of gastrointestinal hormones and T lymphocyte subsets,and relieve the gastric mucosal epidermal injury,and it will not increase adverse reactions.

Abstract:Objective:To analyze the influencing factors of neonatal lactose intolerance,develop a risk prediction model,and validate its predictive performance.Methods:A total of 307 neonates were selected as study subjects.Based on urine galactose test results and clinical manifestations,they were categorized into two groups:a lactose intolerance group(n=59)and a lactose tolerance group(n=248).By comparing the clinical data between the two groups,influencing factors were screened out using multivariate Logistic regression,and a risk prediction nomogram model was subsequently established.The predictive perform-ance of the model was assessed using the ROC curve,calibration curve,and clinical decision curve.Results:The incidence of lac-tase deficiency in newborns was 64.1％(198/307),the incidence of lactose intolerance was 19.22％(59/307),among newborns with lactase deficiency,the incidence of lactose intolerance was 29.8％(59/198).Gestational age serves as a protective factor a-gainst lactose intolerance in newborns,while a family history,prematurity,formula feeding,intestinal infection,antibiotic use,and malnutrition were risk factors for lactose intolerance in newborns(P＜0.05).The ROC curve of the prediction model re-vealed an AUC of 0.924,with a sensitivity of 0.770,a specificity of 0.949,and an optimal Youden index of 0.132.The Hosmer-Lemeshow test showed x2=9.671,with P＞0.05.Conclusion:Multiple high-risk factors contribute to neonatal lactose intoler-ance,and risk prediction models built upon these factors demonstrate good predictive efficacy.It is recommended that clinical in-terventions be implemented promptly and appropriately based on these influencing factors,in order to ameliorate the condition of lactose intolerance.

Abstract:Objective:To explore the efficacy of dydrogesterone and norethindrone on pain relief and clinical symptom im-provement in patients with endometrial polyps.Methods:The clinical data of 98 patients with endometrial polyps were retro-spectively analyzed.They were divided into Group A(n=31,dydrogesterone),Group B(n=33,norethindrone),and Group C(n=34,dydrogesterone+norethindrone)according to different treatment methods.The clinical efficacy,pain,clinical symp-toms(vaginal bleeding time,endometrial thickness,menstrual flow),adverse reactions and recurrence were compared among the three groups.Results:The total clinical efficacy rate after treatment in group A was 74.19％,and the total efficacy rate in group B was 75.76％,and there was no significant difference in the comparison between the groups(P＞0.05),the total effica-cy rate after treatment in group C was 97.06％,which was significantly higher than that in groups A and B(P＜0.05).The VAS scores of pelvic pain,dysmenorrhea and dyspareunia were lower than those before treatment in all three groups,and the a-bove scores were lower than those in Groups A and B after treatment in Group C(P＜0.05).However,there was no significant difference in the comparison of the above scores after treatment in groups A and B(P＞0.05).Endometrial thickness and men-strual flow were lower in the three groups after treatment than before treatment,and endometrial thickness and menstrual flow was less in Group C than in Groups A and B,and the vaginal bleeding time was shorter than in Groups A and B(P＜0.05),there were no significant differences in the above indicators between groups A and B after treatment(P＞0.05).There was no statistically significant difference in the total incidence of adverse reactions among the groups(P＞0.05).The recurrence rate of group C was 2.94％,which was significantly lower than that of groups A and B(P＜0.05).Conclusion:Dydrogesterone and no-rethindrone can be effective in treating endometrial polyps,but the combined treatment of the two is more effective,which is more helpful in relieving the pain of the patients,improving the endometrial condition,shortening the time of vaginal bleeding,and decreasing the recurrence rate of the disease.

Abstract:Objective:To explore the therapeutic effect of myofascial stretch relaxation exercise(MSRE)combined with occupational therapy(OT)on children with spastic cerebral palsy(SCP).Methods:100 children with SCP were divided into OT group and combined group according to different methods,with 50 cases in each group.OT group adopted OT,and com-bined group was treated with MSRE combined with OT,and the treatment period was 8 weeks.The total effective rate of upper limb muscle tension improvement was evaluated in OT group and combined group after treatment.The changes in joint passive range of motion(PROM),development quotient(DQ),gross motor function(GMFM88)development ability evaluation,lan-guage development ability evaluation and upper limb fine motor function measure(FMFM)before and after treatment were an-alyzed.Results:After treatment,the PROM values at various parts,DQ values at 5 energy zones,GMFM88 evaluation,language development ability evaluation and 5 test scores of FMFM ability in OT group and combined group were higher than those be-fore treatment(P＜0.05),and the scores in combined group were higher than those in OT group after treatment(P＜0.05).After treatment,the 10 m walking test(10MWT)time was shorter in OT group and combined group than that before treat-ment,and the combined group had shorter 10MWT time(P＜0.05).The total effective rate of upper limb muscle tension im-provement after treatment in combined group was 90.00％,which was higher than 56.00％in OT group(P＜0.05).Conclu-sion:MSRE combined with OT can improve PROM value,DQ value,motor development ability,language development ability,muscle tension and upper limb fine motor function in children with SCP,and it is of positive significance for the prognosis and rehabilitation.

Abstract:Objective:To explore the influence of local infiltration of bupivacaine liposome on pain and accelerated rehabili-tation effect after total hip arthroplasty(THA).Methods:80 patients who were scheduled to undergo THA were divided into two groups according to different analgesic methods,with 40 cases in each group.The control group and the study group were treated with 100 mg of ropivacaine+0.1 mg of epinephrine+5 mg of dexamethasone and bupivacaine liposome solution for local infiltration analgesia respectively.The postoperative recovery conditions were compared between groups.Results:The pain visual analogue scale(VAS)scores in resting state at different time points after surgery were lower in the study group than those in the control group(P＜0.05),and the dosage of postoperative remedy tramadol was less(P＜0.05),and the time of postoperative first remedy tramadol was later compared with that in the control group(P＜0.05).The QoR scores in the study group at 24,48 and 72 hours after surgery were higher(P＜0.05),and the postoperative hospital stay was shorter compared to the control group(P＜0.05).There was no statistically significant difference in in the incidence rates of adverse reactions be-tween the two groups(P＞0.05).Conclusion:Local infiltration of bupivacaine liposome can alleviate the pain of patients after THA,reduce the use of opioids,and promote the early postoperative health recovery of patients.

Abstract:Objective:To investigate the predictive value of mean whole-lung iodine perfusion(MeanIP)and perfusion de-fect volume ratio(PDVR)as derived from spectral CT in the risk stratification of acute pulmonary embolism(APE).Methods:A retrospective analysis was conducted on 80 patients diagnosed with APE via spectral CT scans.Patients were classified based on clinical and imaging data into high-risk(n=14),intermediate-high risk(n=30),and intermediate-low risk(n=36)groups.Clinical and spectral CT data were compared across these groups,and a Logistic model was developed using perfusion parame-ters to predict risk stratification of intermediate-high or high-risk groups.The model's efficacy was evaluated using the area un-der the ROC curve(AUC),and differences between models were assessed with the DeLong test.Results:Statistically significant differences were observed in MeanIP and PDVR of spectral parameters among the three groups(P＜0.05).The AUCs for the MeanIP,PDVR,and MeanIP+PDVR prediction models were 0.822,0.810,and 0.887,respectively.The DeLong test revealed significant differences between the combined MeanIP+PDVR model and the models using only MeanIP or PDVR,indicating the superior predictive performance of the combined model(P＜0.05).Conclusion:MeanIP combined with PDVR can effectively predict the risk stratification of APE,providing critical imaging evidence for clinical decision-making.

Abstract:Objective:To investigate the changes in coagulation function,inflammatory factors and blood lipid levels in pa-tients with type 2 diabetes mellitus(T2DM)and hyperlipidemic acute pancreatitis(HEAP)and their clinical significance.Methods:95 patients with T2DM combined with HEAP were selected and divided into mild group(n=55)and moderate group(n=40)according to the severity of their condition.The coagulation function indicators,inflammatory factors,and blood lipid levels of all patients were detected and compared.Multivariate logistic regression analysis was used to identify the risk factors for worsening the condition of T2DM combined with HEAP patients.Results:There was a statistically significant difference in the levels of triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and fibrinogen(Fib)between the mild and mod-erate groups(P＜0.05).Multivariate Logistic regression analysis confirmed that TG,LDL-C,and Fib were risk factors for worsening the condition of T2DM patients with HEAP(P＜0.05).The areas under the curve(AUC)of receiver operating characteristic(ROC)curve analysis for predicting disease progression in T2DM patients with HEAP using TG,LDL-C,and Fib were 0.957,0.865,and 0.853,respectively.Conclusion:Changes in coagulation function and blood lipid levels in patients with T2DM and HLAP have certain impact on condition.TG,LDL-C,and Fib can be taken as key monitoring indicators to help time-ly evaluate the severity of the disease and formulate or adjust clinical treatment plans,thus improving the prognosis.

Abstract:Objective:To explore the clinical effect of meticulous capsular dissection technique combined with exposure of recurrent laryngeal nerve(RLN)through cricothyroid space on patients with thyroid carcinoma(TC).Methods:80 patients with TC in the hospital were retrospectively selected,and they were treated with total thyroidectomy(TT).According to the RLN anatomy and exposure scheme adopted during surgery,the above patients were divided into two groups.38 patients in the control group were treated with traditional surgery+arterial exposure of RLN,and the remaining 42 patients in the study group received meticulous capsular dissection+cricothyroid space exposure of RLN.Perioperative conditions,parathyroid func-tion indicators[serum phosphorus,serum calcium,parathyroid hormone(PTH)],complications,quality of life[University of Washington Quality of Life Questionnaire(UW-QOL)]scores and long-term prognosis were compared between the two groups.Results:There were no significant differences in surgical time,intraoperative blood loss and number of lymph node dis-section between the two groups(P＞0.05).At 7 days after surgery,serum phosphorus in the two groups was enhanced com-pared with that before surgery while serum calcium and PTH were reduced compared to before operation(P＜0.05).Com-pared with the control group,serum phosphorus in the study group was lower while serum calcium and PTH were higher(P＜0.05).The study group had lower incidence of postoperative complications than the control group(P＜0.05).At 30 days after surgery,the UW-QOL scores were higher in the study group than those in the control group(P＜0.05).There was no signifi-cant difference in the recurrence rate between both groups after 24 months of follow-up(P＞0.05).Conclusion:Meticulous cap-sular dissection technique+cricothyroid space exposure of RLN has a more significant surgical effect in the treatment of dif-ferentiated TC,and it can effectively protect the parathyroid gland,reduce the occurrence of postoperative complications and im-prove the quality of life.

Abstract:Objective:To analyze the application and prognosis of brain tissue oxygenation(PbtO2)combined with in-tracranial pressure(ICP)monitoring in treat-to-target for acute severe traumatic brain injury(sTBI)with multiple injuries.Methods:A total of 78 patients with sTBI and multiple injuries were selected.They were divided into the control group(receiv-ing ICP monitoring,n=39)and the observation group(receiving ICP combined with PbtO2 monitoring,n=39)according to different treatment methods.The brain-related parameters were compared between the two groups,and the prognosis was eval-uated.Results:The average ICP within 7 days,proportion of patients with intracranial hypertension,and total dosage of mannitol in the observation group were lower than those in the control group,while the average cerebral perfusion pressure was higher than that in the control group(P＜0.05).The proportion of patients with good prognosis and 6-month accumulative survival rate in the observation group were higher than those in the control group(P＜0.05).The average PbtO2 was positively correla-ted with glasgow outcome score in the observation group(P＜0.05).Conclusion:PbtO2 combined with ICP monitoring is of high value in the treatment of sTBI with multiple injuries.It can well reflect the status of cerebral hypoxia and ischemia in pa-tients and improve the short-term prognosis.

Abstract:Objective:To investigate the clinical effect of totally laparoscopic three-step procedure in splenectomy for portal hypertension.Methods:Retrospective analysis of the clinical data of 50 patients with hepatitis b cirrhosis of the portal hyperten-sion were selected and divided into study group(group A)and control group(group B)according to different surgical plans,in-cluding 20 in group A,with a complete laparoscopy of the three steps to remove the macrospleen,the group B had 30 cases,and the spleen was removed by laparoscopic spleen.The operation methods,operation time of splenectomy,intraoperative blood loss,specimen weight,postoperative blood loss,hospital stay,postoperative complications,autologous blood recovery rate,spare foreign blood transfusion rate and laparoscopic conversion rate were compared between the two groups.Results:All operations were completed successfully.Compared with group B,the operation time of splenectomy in group A was shorter(P＜0.05).The intraoperative blood loss in group A was reduced(P＜0.05).There were no significant differences in laparoscopic conver-sion rate,exogenous blood transfusion rate,postoperative complication rate,and specimen weight between the two groups(P＞0.05).The autologous blood recovery rate,postoperative blood loss and length of hospital stay in group A were lower than those in group B(P＜0.05).Conclusion:Laparoscopic secondary splenic pedicle vascular disconnection for splenomegaly has the advantages of high risk of intraoperative bleeding,long operation time and technical difficulty.The total laparoscopic three-step approach is simpler,shorter operation time,less intraoperative blood loss,fewer complications,and has good clinical therapeutic effect.

Abstract:Objective:To investigate the application of two post-core materials in the repair of residual roots and crowns of teeth and analyze the influence on marginal fit and masticatory function.Methods:Clinical data of patients with residual roots and crowns of teeth were included.According to different treatment regimens,they were divided into fiber group(glass fiber post core repair)and metal group(cast metal post core repair),with 59 cases in each group.All patients were followed up for 2 years after repair.The repair effect,marginal fit(USPHS restoration grading),masticatory function(bite force,chewing effi-ciency),periodontal health[gingival index(GI)score,plaque index(PLI)score,and periodontal pocket depth(PD)],quality of life(OHIP-14 score)and the occurrence of adverse events were compared between the two groups.Results:After 2 years of re-pair,the excellent and good rate,USPHS restoration grading,occlusal force and masticatory efficiency in fiber group were high-er than those in metal group(P＜0.05).The GI score,PLI score,PD and scores of dimensions of pain discomfort,functional limitation and ability limitation of OHIP-14,and the total adverse events rate were lower in fiber group than those in metal group(P＜0.05).Conclusion:Compared with cast metal post core,glass fiber post core has better repair effect and marginal fit in the repair of residual roots and crowns of teeth,and the latter one can effectively improve the masticatory function,periodon-tal health and quality of life,and has higher safety.

Abstract:< positive > 1 case data the patient, a 31 year old male, was admitted to the hospital because of "night sweat for 4 months, nasal erosion for 1 month". Four months ago, there was no obvious inducement for night sweats, accompanied by slight pharyngeal pain, decreased appetite and water reflux, accompanied by weight loss, and slight obstruction of bilateral nasal cavities. One month ago, after nose digging, erosion at the columella was found, which gradually expanded to the bilateral nasal vestibule, accompanied by nasal pain and purulent and smelly nasal secretions, without epistaxis, cough, expectoration, hearing loss, tinnitus, abdominal pain, diarrhea, etc. The patient did not pay attention to it, and his condition gradually aggravated, so he came to the hospital for treatment in emergency. The patient complained of EB virus hepatitis 5 years ago and recovered after treatment; Denied the history of drug allergy; Denied a family history of hereditary disease.

Abstract:< positive >Sodium valproate, also known as sodium valproate (VPA), is a broad-spectrum antiepileptic drug, which is widely used in the treatment of epilepsy in adults and children, as well as in the treatment of migraine, febrile seizures, tics and other diseases in children. VPA is safer than other antiepileptic drugs, such as ethylsuccinamide and lamotrigine [1], but there are still adverse reactions. Common adverse reactions are mainly distributed in the digestive system, nervous system, skin, blood system, etc. [2]. This case suggests that hypothyroidism is a rare adverse reaction of VPA. 1 case data the child, female, born on January 2, 2016, was 5 years old at the time of treatment, and came to our hospital on January 11, 2021 for the main reason of "finding Lengshen 10+d". The family members complained that the child had no obvious inducement to appear "dazed and absent-minded" for more than 10 days. At each attack, the child would suddenly stop the ongoing activities, his eyes were dull, he should not shout, he was in a dazed state, and he did not respond to the surrounding environment and external stimuli.

Abstract:Objective:To explore the effect of cluster nursing program based on the concept of enhanced recovery after sur-gery(ERAS)on postoperative delirium(POD)in elderly patients with hip fracture.Methods:168 elderly patients with hip frac-ture were divided into control group(n=84)and observation group(n=84)according to different nursing methods.The con-trol group was given routine perioperative nursing,and the observation group was given cluster nursing based on ERAS con-cept.The incidence of postoperative POD(incidence,duration),the incidence of postoperative hypoxemia,the visual analogue scale(VAS)of pain on the first day after operation,the total sleep time on the first day after operation,the incidence of POD-related adverse events and postoperative recovery(Orientation recovery time after anesthesia,hospitalization time)were com-pared between the two groups.Results:Compared with the control group,the incidence of POD in the observation group(26.19％vs.10.71％)was lower,and the duration of POD[(3.70±0.95)d vs.(2.37±0.72)d]was shorter(P＜0.05).The incidence of hypoxemia in the observation group was lower than that in the control group(15.48％vs.8.33％,P＞0.05).Compared with the control group,the VAS score of the observation group on the first day after operation was lower[(4.26±1.04)points vs.(2.61±0.75)points,P＜0.001],and the total sleep time on the first day after operation was longer[(3.71±0.72)h vs.(5.30±0.64)h,P＜0.001].The total incidence of POD-related adverse events in the observation group was lower than that in the control group(11.90％vs.3.57％,P＜0.05).Compared with the control group,the Orientation recov-ery time after anesthesia[(4.11±0.97)h vs.(2.55±0.68)h]and hospitalization time[(7.64±1.53)d vs.(6.76±1.28)d]in the observation group were shorter(P＜0.05).Conclusion:The cluster nursing program based on the concept of ERAS can effectively reduce the incidence and duration of POD in elderly patients with hip fracture,reduce the occurrence of POD-re-lated adverse events,and accelerate postoperative recovery.